26-723 Updates to Quality Incentive Pool and Directed Payment Programs

Date: 05/28/26

QIP data will be reported by the Plan starting June 2026

New data sharing and reporting requirements will change how quality performance data is reported for Medi‑Cal quality incentive and directed payment programs. These updates affect Quality Incentive Pool (QIP) programs and how provider‑level quality data is submitted and supported.

To support this change, updates have been made to QIP reporting processes, and dedicated contact inboxes have been established for directed payment programs.

Change to QIP data reporting – effective June 2026

Currently, hospitals calculate and submit their own QIP performance rates. Beginning in June 2026, this process will change.

Starting at that time, Health Net and Community Health Plan of Imperial Valley will collect and report QIP performance data on behalf of physicians, practitioners and other providers. This updated approach is intended to:

• Improve data consistency and accuracy.
• Simplify reporting requirements.
• Reduce administrative burden for physicians, practitioners and other providers.

No action is required at this time. Additional details will be shared closer to implementation.

Dedicated support for directed payment programs

Each incentive program now has a dedicated contact email to ensure questions are routed to the appropriate team. Physicians, practitioners and other providers should use the applicable contact below for program‑specific support or guidance.

Questions or need more information

For details and requirements, refer to the California Department of Health Care Services All Plan Letter 25-015 (PDF).

For general questions about this change, contact Community Health Plan of Imperial Valley at 833-236-4141.

Directed payment program and Email link
Children and Youth Behavioral Health Initiative
District and Municipal Public Hospital Directed Payment Program
Enhanced Payment Program
Private Hospital Directed Payment Program
Directed Payments for Adverse Childhood Experiences
Directed Payments for Developmental Screening Services
Equity and Practice Transformation (EPT) Directed Payment Program
Long Term Care Fee-For-Service-Equivalent Base Directed Payment
Organ and Bone Marrow Transplants Services
Proposition 56 Directed Payments for Family Planning Services
QIP for DPHs and DMPHs
Skilled Nursing Facility (SNF) Workforce and Quality Incentive Program (WQIP)
Targeted Rate Increases

 

This information applies to Physicians, Practitioners, Participating Physician Groups (PPGs), Hospitals, Ancillary Providers, Community Supports (CS) Providers, Enhanced Care Management (ECM) Providers, and Behavioral Health Providers.

This information applies to Medi-Cal in Imperial County.